Workshop on reimbursement mechanisms to achieve UHC – organised by the World Health Organisation and international Decision Support Initiative

On the 13thJuly 2016, Kalipso Chalkidou and Else Krajenbrink (GHD), Amanda Glassman (CGD), Karen Hofman (PRICELESS) and Yot Teerawattananon and Waranya Rattanavipapong (HITAP) participated in a WHO and iDSI co-hosted workshop in Geneva, Switzerland. The 3 day workshop aimed to cope out the content and process for developing guidance on HTA as a tool for reimbursement decisions to establish Universal Health Coverage (UHC).

The workshop narrative derived from the global need to develop UHC as a way to improve health, expressed in the SDG 3.8 “achieve universal health coverage (UHC), including financial risk protection, access to quality essential health services and access to safe, effective, quality and affordable essential medicines and vaccines for all”. The basis for the workshop was a document published by CGD on priority setting in health (1).

This 3 day workshop had the overall objective of scope out the content and process for developing guidance on HTA as a tool for reimbursement decisions. A specific deliverable at the end of the workshop was a document outlining:

Key issues that need to be tackled in the guidance

Insights and learnings from participants that can inform each of these issues, including where possible, identification of “landmark” documents and countries examples of good/bad practice

Recommendations for research or data collection on information gaps.

The participants were invited based on their involvement in the Health Technology Assessment (HTA)/priority setting process in their respective countries, and a distinction was made between countries in different levels of development of HTA/priority-setting system (established or working towards UHC). There were representatives from South Africa, Chile, Thailand, the UK, the United States, the Philippines, Croatia, Norway, Switzerland, and other countries. The participants present worked in a wide range of organisation: HTA research – University of Wits and Indonesia, HTA agencies – NICE and HITAP, the Ministry of Health – Zambia, Chile and Vietnam, regional HTA networks EUnetHTA and HTAi, and global funders – BMGF, the UK DFID, GAVI and the Global Fund.

Over the three days, the participants listened to, participated in and prepared sessions on: the scope of work of an HTA mechanism; how are countries setting up HTA mechanisms; legal frameworks for HTA mechanisms; minimum capacities for HTA mechanisms; the role of regional and global partners and networks; criteria to be used at different stages of the HTA process and monitoring the effectiveness of HTA mechanisms. Alongside these sessions, breakout groups discussed questions as: steps and principles for HTA processes; what are the main considerations in landscape/context/mandate analysis and criteria and negative/positive lists of implementing HTA.

The workshop was a success, with a strong interest from the WHO to collaborate with iDSI in future work. IDSI and the WHO are discussing next steps, and there has been a strong interest from the participants to participate in the development of this document.